Approximately 1.5% of patients undergoing total joint replacement suffer from infection in the joint. These infections must be eradicated and to do so in most cases the joint has to be removed, the infection eliminated or eradicated and subsequently (generally after a substantial period of time) a further or substitute joint is implanted.
The general procedure for eradication of the infection is to remove the joint prothesis and the infected tissue, insert antibiotic loaded cement beads into the cavity so formed and leave the beads in this position for a period of six to twelve weeks or until the infection has been eradicated.
When the infection has been eliminated the inserted cement beads are removed and a new permanent replacement prothesis is implanted.
Obviously in following this procedure during the portion of time (from six to twelve weeks) between the insertion of the antibiotic-loaded beads and until the infection is eradicated the use of the infected limb is severely restricted and the patient usually remains substantially bedridden and confined to hospital over that period.
In treating infected replacement protheses it is also known to use a bone cement impregnated with antibiotic to secure a new permanent prothesis in place without the application of the beads to the cavity i.e. immediately following removal of the previously applied prothesis. Also it is much easier to remove a temporary joint replacement than such a permanent replacement should the treatment be unsuccessful.